Obstructive Sleep Apnea Impaired Oral Function & Aging

By Arthur M. Strauss, DDS

Obstructive Sleep Apnea

Impaired Oral Function & Aging

The prevalence of obstructive sleep apnea increases with age. Among patients 65 years and older, there is a two- to three-fold higher prevalence compared to patients 30 to 64 years old. The prevalence of chronic illness also increases significantly with age.

My intent is to help you understand how the origin of obstructive sleep apnea is the same as that of all or most all chronic illness.

The airway is essentially a rigid or semi-rigid tube extending from the mouth to the trachea or wind pipe. It is, for the most part, passive and static, except for where the oral-airway merges with the throat. In the front “door” of the oral-airway is the tongue, the primary functions of which are

Breathing,

Swallowing, and,

Speaking.

The size, shape, and position of the mouth, including the teeth and jaws, influence the posture, position and muscle tone of the tongue as it relates to the mouth and the throat (airway). This impacts breathing round-the-clock, including partial or full obstruction of the airway in both “daytime” and “nighttime” apnea. In turn, this impacts all body functions.

Adequate airway space is the bodys first priority for survival as it either allows or prevents our airflow and breathing. If the tongue is in the way, the body does whatever is needed to rectify this through compensatory behavior. I believe that the impact on our body, mind and spirit associated with these compensations is the source of most of our chronic health problems.

Farrand C. Robeson, D.D.S. has identified these compensations as

Forward head posture

“Fight or Flight” state

Clenching/grinding of the teeth

Forward head posture stimulates reactions to bring the body to its center of gravity at the expense of the entire musculoskeletal system, affecting all muscles and joints and pain cycles associated with this.

Fight or flight state is everything we associate with the word “stress”. It is the result of the secretion of adrenaline and related hormones in response to the message of “emergency”, which is triggered by even a minute obstruction of the airway. This not only effects the cardiovascular system (strokes, heart attacks, right sided heart failure) it also imbalances the entire endocrine system, which is intimately connected to all of the other systems in the body the nervous system, digestive system (including digestion, adsorption and assimilation), immune system, circulatory system, musculoskeletal system, etc.

Clenching and grinding of the teeth are the source of most temporo-mandibular joint problems and dysfunctions that appear to be implicated in an increasing number of medical conditions.

How our body is compensating at any point in time, how the compensations relate to one another and the immediate, far reaching, short term and long-term affects of this is impacted by our genetic disposition, behavior and environment. The cumulative effect of this increases with aging and usually snowballs to our final breath.

The focus of oral appliance therapy for impaired oral function and in the treatment of sleep apnea is to create a more harmonious relation of the tongue and the airway and reduce the bodys need to compensate for this. The response to what degree and how effectively this is managed can have far reaching effects on your present life and how well you age.